Bilateral Internal Iliac Artery Embolization Results in an Unacceptably High Rate of Complications in Patients Requiring Pelvic/Acetabular Surgery
| Autor: | Lisa Husak, Armen Martirosian, Jason A. Davis, Gustavo Garcia, Eric Lindvall |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty animal structures medicine.medical_treatment Iliac Artery Risk Assessment 03 medical and health sciences Fracture Fixation Internal Fractures Bone Young Adult 0302 clinical medicine Postoperative Complications Trauma Centers medicine.artery Medicine Internal fixation Humans Orthopedics and Sports Medicine In patient Embolization Pelvic Bones Aged Retrospective Studies High rate 030222 orthopedics business.industry Trauma center Angiography 030208 emergency & critical care medicine Acetabulum General Medicine Middle Aged Internal iliac artery Combined Modality Therapy Embolization Therapeutic United States Surgery Treatment Outcome Orthopedic surgery Female business Complication Follow-Up Studies |
| Zdroj: | Journal of orthopaedic trauma. 32(9) |
| ISSN: | 1531-2291 |
| Popis: | OBJECTIVES To assess complication rates in patients undergoing open reduction internal fixation (ORIF) of pelvic/acetabular fractures with and without pelvic angiography embolization (PAE). DESIGN Retrospective case series. SETTING Level 1 Trauma Center. PATIENTS/PARTICIPANTS One hundred eleven patients with pelvic or acetabular fractures that required orthopaedic fixation. INTERVENTION Retrospective analysis of outcomes in patients who underwent ORIF of pelvic/acetabular fractures with and without PAE. MAIN OUTCOME MEASUREMENTS Comparison of surgical wound infections, necrosis, and/or fracture nonunions between the PAE group and a control group (no PAE). RESULTS Final study groups consisted of 50 patients in the PAE group and 61 patients in the control group. Ninety-six percent of patients underwent nonselective PAE. Significantly higher complications were noted in the PAE group than in the control group (20% compared with 4.9%; P = 0.020). In addition, posterior surgical approaches combined with internal iliac artery embolization represented the highest complication rate. CONCLUSIONS Patients requiring PAE and pelvic/acetabular ORIF should undergo a multidisciplinary treatment approach with the trauma surgeon, interventional radiologist, and orthopaedic surgeon before PAE being performed to decrease complications and avoid nonselective bilateral internal iliac artery embolization. LEVEL OF EVIDENCE Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
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